Worsened long-term outcomes and postoperative complications in octogenarians with lung cancer following mediastinal lymph-node dissection.
We evaluated the effects of mediastinal lymph-node dissection on outcomes in octogenarians with primary lung cancer. Outcomes and postoperative complications were retrospectively investigated in 48 octogenarians with anatomically resected lung cancer, of whom 23 underwent a mediastinal lymph-node dissection (ND2 group) and 25 a limited lymphadenectomy (ND0-1 group). Forty-three patients underwent a lobectomy, two a pneumonectomy, and three a segmentectomy. The five-year survival rate for all was 35%, while that for those in pathological stage I was 43.3% and for those in stage II+III was 21.2%. As for lymph node dissection, the five-year survival rate for the ND0-1 group (54.3%) was superior to that for the ND2 group (21.7%) (P=0.022). For patients in pathological stage I, those rated ND0-1 had a better five-year survival than those rated ND2 (61.9% vs. 28.6%) (P=0.041). In addition, mediastinal lymph-node dissection increased the incidence of postoperative cardiac complications (P=0.004). Our results indicate that major pulmonary resection with mediastinal lymph-node dissection is associated with a higher rate of mortality in octogenarians with lung cancer.
Chida
Masayuki
M
Department of Thoracic Surgery, Dokkyo Medical University, Shimotsuga, Tochigi, Japan. chida-ths@umin.ac.jp
Minowa
Muneo
M
Karube
Yoko
Y
Eba
Syunsuke
S
Okada
Yoshinori
Y
Miyoshi
Shinichiro
S
Kondo
Takashi
T
D000367:Age Factors; D000369:Aged, 80 and over; D002985:Clinical Protocols; D006331:Heart Diseases / Q000209:etiology / Q000401:mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000401:mortality; D008482:Mediastinum / Q000601:surgery*; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000009:adverse effects; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors